The goal of the disease management programs such as heart failure, chronic obstructive pulmonary disease (COPD), diabetes, sleep apnea disease management programs, including those offered via remote patient management systems, is to empower patients to control their complex chronic condition. Similarly, lifestyle change programs such as weight management, smoking cessation, or physical activity programs are meant to empower consumers to change their behavior. The key component of both types of programs, i.e. disease management and lifestyle, is therefore coaching the patient. Coaching addresses the following:                Improving knowledge about the chronic condition or specific aspects of these;        Changing attitudes of the patients toward certain behaviors that they need to adopt in order to adhere to the prescribed medication and lifestyle goals;        Guiding a patient through stages of change, e.g., from pre-contemplation, through contemplation, action and maintenance; and        Removing perceived barriers and enforcing the benefits that a patient has toward the specific behavior or a goal.        
Patient non-compliance decreases the efficacy of pharmacological and non-pharmacological therapy and exposes the patient to clinical destabilization, which can lead to exacerbating disease symptoms. Evidence from clinical trials and validated insights show that the most commonly identified cause of disease worsening, e.g. Heart Failure (HF) decompensation, is non-compliance with medication, low sodium diet, fluid restriction and physical activity. Non-compliance is the precipitating factor of exacerbation, leading to poor clinical outcomes. Therefore, interventions overcoming low patient compliance are needed.
The coaching of patients may be managed with so called remote patient management systems, which are also known as telehealth systems. The coaching of patients may be coded into executable care plans which may be executed by an application hosting device which the patient has access to. An application hosting device may present or deliver so-called content elements. A common way to assess the knowledge, compliance, self-care behavior, etc. of a patient is through questionnaires, e.g., surveys or quizzes. This is also true in many personal healthcare systems and approaches, where scientifically validate questionnaires are used to assess knowledge as well as other cognitive, behavioral and emotional parameters.